Comparative study analysing maternal recovery after childbirth according to Marjory Gordon’s Patterns
Abstract
Objective: Analyse if there is any difference in recovery rate according to their puerperium stage depending on perineal lesion.
Material and method: Prospective longitudinal descriptive quantitative study, following the Marjory Gordon’s Functional Health Patterns. Data collection will be performed in three phases (immediate, clinical and remote puerperium), through semi-structured interview completed in first instance in a face-to-face interview and phone call interview at 10 and 30 days, respectively.
Results: In Spain there is an episiotomy, induction and assisted delivery rate much higher than recommended. Episiotomy technique lead to significant tear (16,7%) in this study. During immediate puerperium, women who were practiced an episiotomy shown mobility difficulties (p=0,0005), elimination (p=0,0007), baby care (p=0,015), rest (p=0,15) and perceived pain (p=0,005), whereas in the clinical puerperium are affected only mobility (p=0,05), elimination (p=0,042) and perceived pain (p=0,006). After 30 days, remote puerperium, there is not statistical significant differences in both groups. More research is needed to confirm these facts as well as provide new knowledge.
Conclusions: Episiotomy produce more negative effects than spontaneous tears at the immediate and clinical puerperium of women. Pain produced by this technique as a short, medium and long term limit many daily activities of women.
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References
Arriaza Romero PD, Granados León S, Martinez Atienza JF, Sánchez Jiménez C. Técnicas Básicas de Enfermería. 1ª ed. Madrid: Ediciones Paraninfo; 2013 [citado 07 May 2016]. 670 p. Disponible en: https://books.google.es/books?id=C_1RAgAAQBAJ&printsec=frontcover&hl=es&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false
Cabay Basantes MJ, Aguagallo T, Marina V. Principios bioéticos en el cuidado de Enfermería y la satisfacción en las necesidades de seguridad y autoestima en las pacientes con labor de parto y puerperio atendidas en el servicio de ginecología del Hospital Provincial General Docente Riobamba. Murcia [Tesis Doctoral en Internet]. Riobamba: Universidad Nacional de Chimborazo; 2013 [citado 07 May 2016]. 296 p. Disponible en: http://dspace.unach.edu.ec/bitstream/51000/1225/1/UNACH-EC-ENFER-2013-0021.pdf
Cruz Maroto E. Incidencia y prevalencia del dolor perineal tras parto vaginal [investigación para Tesis Doctoral]. Reduca [Internet]. 2009 [citado 07 May 2016]. Disponible en: www.revistareduca.es/index.php/reduca-enfermeria/article/view/59/52
Episiotomía. Oxford Dictionaries [Internet]. 2016 [citado 07 May 2016]. Disponible en: http://www.oxforddictionaries.com/es/definicion/espanol/episiotomia
Organización de Consumidores y Usuarios. Demasiadas episiotomías en España. OCU [Internet]. 2015 Feb [citado 07 May 2016]. Disponible en: http://www.ocu.org/salud/derechos-paciente/noticias/episiotomias
Alperin M, Krohn M, Parviainen K. Episiotomy and increase in the risk of obstetrics laceration in a subsequent vaginal delivery. Obstet Gynecol [Internet]. 2008 Jun [citado 07 May 2016]; 111(6):1274-1278. Disponible en: https://www.researchgate.net/publication/5334611_Episiotomy_and_Increase_in_the_Risk_of_Obstetric_Laceration_in_a_Subsequent_Vaginal_Delivery
European Perinatal Health Report: Health and Care of Pregnant Women and Babies in Europe in 2010. Euro-Peristat Network [Internet]. 2010 [citado 07 May 2016]. Disponible en: http://www.europeristat.com/images/doc/EPHR2010_w_disclaimer.pdf
Recio Alcaide A. La atención al parto en España: Cifras para reflexionar sobre un problema. Dialnet [Internet]. 2015 [citado 07 May 2016]; 18:13-26. Disponible en: https://dialnet.unirioja.es/descarga/articulo/5106931.pdf
Grupo de trabajo de la Guía de Práctica Clínica sobre Atención al Parto Normal. Guía de Práctica Clínica sobre la Atención al Parto Normal. Plan de Calidad para el Sistema Nacional de Salud del Ministerio de Sanidad y Política Social. Agencia de Evaluación de Tecnologías Sanitarias del País Vasco (OSTEBA). Agencia de Evaluación de Tecnologías Sanitarias de Galicia (Avalia-t). 2010 [citado 07 May 2016]. Guías de Práctica Clínica en el SNS: OSTEBA Nº 2009/01. Disponible en: http://www.guiasalud.es/GPC/GPC_472_Parto_Normal_Osteba_compl.pdf
Ballesteros Meseguer C. Factores que Condicionan la Práctica de la Episiotomía en el Marco de la Estrategia de Atención al Parto Normal en un Hospital Universitario de la Región de Murcia [Tesis Doctoral en Internet]. Murcia: Universidad de Murcia; 2014 [citado 09 May 2016]. 296 p. Disponible en:http://www.tdx.cat/bitstream/handle/10803/134965/TCBM.pdf?sequence=1
Sevilla Hernández MG. Situación actual del procedimiento de la episiotomía en el Complejo Hospitalario Universitario del Área II del Servicio Murciano de Salud [Trabajo Fin de Grado]. Murcia: Universidad de Murcia; 2015 [citado 07 May 2016].
López A. La madre no controla el parto. Diario online El Mundo [Internet]. 2015 Feb [citado 07 May 2016]. Disponible en: http://www.elmundo.es/salud/2015/09/14/55f1cd3122601d47428b45a5.html
Ministerio de Sanidad, Servicios Sociales e Igualdad. Observatorio de Salud de las Mujeres (OSM). Informe del Estado de Situación de la Atención al Parto Normal en el Sistema Nacional de Salud. 2012 [citado 09 May 2016].
Ghosh C, Mercier F, Couaillet M, Benhamou D. Quality-assurance program for the improvement of morbidity during the first three postpartum days following episiotomy and perineal trauma. Acute Pain [Internet]. 2004 [citado 09 May 2016]; 6:1-7. Disponible en: https://www.researchgate.net/publication/244797207_Quality-assurance_program_for_the_improvement_of_morbidity_during_the_first_three_postpartum_days_following_episiotomy_and_perineal_trauma
Juste-Pina A, Luque-Carro R, Sabater-Adán B, Sanz-de Miguel E, Viñerta-Serrano E, Cruz-Guerreiro E. Episiotomía selectiva frente a episiotomía rutinaria en nulíparas con parto vaginal realizado por matronas. Matronas Prof [Internet]. 2007 [citado 09 May 2016]; 8 (3-4):5-11. Disponible en: http://www.federacion-matronas.org/revista/matronas-profesion/sumarios/i/6702/173/episiotomia-selectiva-frente-a-episiotomia-rutinaria-en-nuliparas-con-parto-vaginal-realizado-por-matronas
Amorim Francisco A, Junqueira Vasconcellos de Oliveira SM, Barbosa da Silva FM, de Oliveira Santos J, Leister N, Gonzalez Riesco ML. Efecto del dolor perineal en las actividades de mujeres sometidas a episiotomía. Index Enferm [Internet]. 2012 Sept [citado 09 May 2016]; 21(3):150-154. Disponible en: http://scielo.isciii.es/scielo.php?pid=S1132-12962012000200009&script=sci_arttext&tlng=pt
Dannecker C, Hillemanns P, Strauss A, Hasbargen U, Hepp H, Anthuber C. Episiotomy and perineal tears presumed to be imminent: randomized controlled trial. Acta Obstet Gynecol Scand [Internet]. 2004 Apr [citado 11 May 2016]; 83(4):364-8. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/15005784
Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J Jr, Lohr KN. Outcomes of routine episiotomy: a systematic review. JAMA [Internet]. 2005 May [citado 11 May 2016]; 293(17):2141-8. Disponible en: http://jama.jamanetwork.com/article.aspx?articleid=200799
Grupo de trabajo de la Guía de práctica clínica de atención en el embarazo y puerperio. Guía de práctica clínica de atención en el embarazo y puerperio. Ministerio de Sanidad, Servicios Sociales e Igualdad. Agencia de Evaluación de Tecnologías Sanitarias de Andalucía; 2014 [citado 11 May 2016]. Guías de Práctica Clínica en el SNS: AETSA 2011/10. Disponible en: http://www.msssi.gob.es/organizacion/sns/planCalidadSNS/pdf/Guia_practica_AEP.pdf
Mueller-Lissner SA. and Wald A. Constipation in adults. BMJ Clin Evid [Internet]. 2010 Jul [citado 11 May 2016]. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217654/pdf/2010-0413.pdf
Alexandre CW, Kimura AF, Tsunechiro MA, Oliveira SMJV. A interferência da dor nas atividades e necessidades da puérpera. Rev Nurs [Internet]. 2006 [citado 12 May 2016]; 93(3):664-668. Disponible en: https://www.researchgate.net/publication/285819108_A_interferencia_da_dor_nas_atividades_e_necessidades_da_puerpera
Andrews V, Thakar R, Sultan AH, Jones PW. Are mediolateral episiotomies actually mediolateral? BJOG [Internet]. 2005 Aug [citado 12 May 2016]; 112(8):1156-1158. Disponible en: http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2005.00645.x/full
Sartorato Beleza AC, Jorge Ferreira CH, de Sousa L, Spanó Nakano AM. Mensuração e caracterização da dor após episiotomia e sua relação com a limitação de atividades. Rev Bras Enferm [Internet]. 2012 Mar-Apr [citado 12 May 2016]; 65(2):264-8. Disponible en: http://www.scielo.br/pdf/reben/v65n2/v65n2a10.pdf
Pimenta CAM. Dor: manual clínico de enfermagem. 2000 [citado 12 May 2016].
Klein MC, Gauthier RJ, Robbins JM, Kaczorowski J, Jorgensen SH, Franco ED et al. Relationship of episiotomy to perineal trauma and morbility, sexual disfunction, and pelvic floor relaxation. Am J Obstet Ginecol [Internet]. 1994 Sept [citado 13 May 2016]; 171:591-598. Disponible en: https://www.researchgate.net/publication/15107455_Relationship_of_episiotomy_to_perineal_trauma_and_morbidity_sexual_dysfunction_and_pelvic_flor_relaxation
Williams et al, 2007, citado por Browne M, Jacobs M, Lahiff M, Miller S. Perineal injury in nulliparous women giving birth at a community hospital: reduced risk in births attended by certified nurse-midwives. J Midwifery Womens Health [Internet]. 2010 May-Jun [citado 13 May 2016]; 55(3):243-2499. Disponible en: http://www.medscape.com/viewarticle/723966
Sule ST, Shittu SO. Puerperal complications of episiotomies at Ahmadu Bello University Teaching Hospital Zaria, Nigeria. East Afr Med J [Internet]. 2003 Jul [citado 13 May 2016]; 80(7):351-356. Disponible en: http://www.uonbi.ac.ke/journals/files/journals/1/articles/557/submission/review/557-2058-1-RV.pdf
Dannecker C, Hillemanns P, Strauss A, Hasbargen U, Hepp H, Anthuber C. Episiotomy and perineal tears presumed to be imminent: randomized controlled trial. Acta Obstet Gynecol Scand [Internet]. 2004 Apr [citado 13 May 2016]; 83(4):364-368. Disponible en: http://onlinelibrary.wiley.com/wol1/doi/10.1111/j.0001-6349.2004.00366.x/full
Robinson JN. Approach to episiotomy. UpToDate [Internet]. 2016 Apr [citado 13 May 2016]. Disponible en: http://www.uptodate.com/contents/approach-to-episiotomy
Turmo M, Echevarría M, Rubio P, Almeida C. Cronificación del dolor tras episiotomía. Rev Esp Anestesiol Reanim [Internet]. 2015 [citado 15 May 2016]; 62(8): 436-442. Disponible en: http://www.sciencedirect.com/science/article/pii/S0034935614002941
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